facebook tracking Major hip and knee joint replacement or reattachment of lower extremity with major complications or tota cost in North Carolina: 4 hospitals compared (DRG 469)

Major hip and knee joint replacement or reattachment of lower extremity with major complications or tota in North Carolina

What 4 hospitals in North Carolina charged and were paid for a Medicare hospital stay for major hip and knee joint replacement or reattachment of lower extremity with major complications or tota (DRG 469), from 2024 Medicare claims.

DRG 469 Inpatient 2024 Medicare data
Average charge $124,302 Hospital list price billed
Average payment $29,736 Medicare + patient + other payers
Medicare paid $25,891 Average per stay
State rank #4 of 10 1 = lowest average payment

Hospitals in North Carolina billed an average of $124,302 for major hip and knee joint replacement or reattachment of lower extremity with major complications or tota, about 4.2 times the average total payment of $29,736. That payment is 9% below the U.S. average of $32,812.

These are averages for patients with original (fee-for-service) Medicare. Private insurance pays different, negotiated prices, and what you owe depends on your plan's deductible and coinsurance. Use these figures to compare hospitals, not as a quote.

Paid $29,736Billed $124,302

About 24¢ was paid for every $1 hospitals in North Carolina billed for this stay.

Medicare prices this stay in 2 versions, by how sick the patient was. Compare them in North Carolina:

North Carolina hospitals: major hip and knee joint replacement or reattachment of lower extremity with major complications or tota

Every North Carolina hospital that billed Medicare for this stay at least 11 times. Click a column to sort.

Hospital Stays Avg charge Avg payment Medicare paid
New Hanover Regional Medical CenterWilmington 21 $86,738 $27,678 $26,156
Duke University Medical CenterDurham 13 $151,104 $41,728 $30,405
Memorial Mission Hospital and Asheville Surgery CeAsheville 12 $183,918 $28,343 $26,370
Presbyterian HospitalCharlotte 12 $101,387 $21,737 $20,056
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Lowest and highest payments in North Carolina

Among hospitals with at least 11 Medicare hospital stays. Differences reflect local wage costs, teaching status and how sick patients were, as well as price.

Major hip and knee joint replacement or reattachment of lower extremity with major complications or tota in other states

Questions

How much does major hip and knee joint replacement or reattachment of lower extremity with major complications or tota cost in North Carolina?

In 2024 Medicare data, a hospital stay for major hip and knee joint replacement or reattachment of lower extremity with major complications or tota (DRG 469) at 4 hospitals in North Carolina was billed at $124,302 on average, while the average total payment was $29,736, of which Medicare paid $25,891. Your own cost depends on your insurance, deductible and the hospital.

Why are hospital charges so much higher than payments?

Charges are a hospital's list prices. Medicare pays fixed rates set in advance, and private insurers negotiate their own discounts, so almost nobody pays the full charge. For this stay in North Carolina, average charges were 4.2 times the average payment. Uninsured patients can ask the hospital about its financial assistance (charity care) policy and cash prices.

Source: CMS, Medicare Inpatient Hospitals by Provider and Service, 2024. Average total payment includes Medicare's payment, the patient's deductible and coinsurance, and any other payer. CMS omits hospitals with fewer than 11 hospital stays for privacy. About the data.